Skin Deep

This summer three British transsexuals who want to be women won their appeal against the local health authority which had refused them a sex-change operation. In a case widely publicized in the UK, the Court of Appeal upheld an earlier High Court ruling that the authority had acted unlawfully, without consideration of what was “the proper treatment of a recognized illness.” The significance of this is that transsexuals in Britain, of whom around 1,000 are currently awaiting surgery, will now be able to demand to have their sex-change operations on the National Health. The solicitor representing the transsexuals commented at the end of this long-drawn-out case that the estimated å£200,000 spent on it could have funded twenty sex-change operations.

One of the transsexuals, known as “A,” was quoted as saying that the sex-change operation was essential to ending years of misery. “A” regards her male physique as a “deformity.” The agonizing sense of dislocation of a man who has been “born into the wrong body, and should really be a girl” emerged earlier in Jan Morris’s Conundrum (1974), a small classic of twentieth-century autobiography, the most convincing account of a sex change yet. Trapped in her male body, and known then as James, Morris endured military service (the 9th Lancers) and newspaper journalism (The Guardian and The Times), covering the war in Palestine and the ascent of Everest before taking the flight to Casablanca, where her penis and testicles were surgically removed and her vagina created in an expensive private clinic. No NHS option in the Britain of that time.

James/Jan Morris equated her conundrum with ideas of soul or self: “I think of it not just as a sexual enigma, but as a quest for unity.” Since then cultural historians have been productively exploring the connections between people’s perceptions of the body they see themselves as, ideally, inhabiting and their happiness of mind. In his earlier study of aesthetic surgery, Creating Beauty to Cure the Soul,1 Professor Sander L. Gilman gave a fascinating account of the origins of these ideas, tracing them back to Enlightenment philosophers’ understanding of a beautiful body as the visible expression of human virtue. Conversely, ugly bodies signified unhealthy spirits. Follow through this argument and the Jew’s nose comes to represent the Jew’s permanently sick soul.

In Creating Beauty to Cure the Soul Gilman concentrates on the complex relationship between aesthetic surgery and psychoanalysis in the late nineteenth and twentieth centuries, which offered parallel possibilities of transformation, one of the body, the other of the mind. While retracking over some of the same material, Making the Body Beautiful is a broader-based, less overtly academic work, written with some of the breeziness of Roy Porter’s energetic sociomedical overviews and containing an unforgettable collection of historical before-and-after photographs. Gilman’s book also differs in its focus from Elizabeth Haiken’s Venus Envy: A History of Cosmetic Surgery.2 Where Haiken drew the majority of her examples and conclusions from the US, Gilman ranges much more widely. His book…

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